| Roderick E Mcmillen Dds A Dental Corp | |
|
825 Sequoia Circle Fort Bragg CA 95347 | |
| (707) 964-0242 | |
| (707) 964-0244 |
| Full Name | Roderick E Mcmillen Dds A Dental Corp |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 825 Sequoia Circle, Fort Bragg, California |
| Authorized Official Name and Position | Roderick E Mcmillen (PRESIDENT OF SMALL CORP) |
| Authorized Official Contact | 7079640242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roderick E Mcmillen Dds A Dental Corp 825 Sequoia Circle Fort Bragg CA 95347 Ph: (707) 964-0242 | Roderick E Mcmillen Dds A Dental Corp 825 Sequoia Circle Fort Bragg CA 95347 Ph: (707) 964-0242 |
| NPI Number | 1215037684 |
|---|---|
| Provider Enumeration Date | 09/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215037684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18587 (California) | Primary |
Neil S Wilensky Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 895 River Drive, Fort Bragg, CA 95437 Phone: 707-961-4270 Fax: 707-961-4275 |